BRIAN GAMBORG

LAKE CHARLES, LA
NPI1295795755
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: LA  023359)
Enumeration Date2006-03-27
Last Update Date2022-04-29
Business Address
BRIAN GAMBORG
1525 OAK PARK BLVD
LAKE CHARLES, LA 70601-8849
Phone number: 337-494-6767
Mailing Address
BRIAN GAMBORG
PO BOX 123453 DEPT 3453
DALLAS, TX 75312-3453
Phone number: 337-494-2921